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Posted by Ed Huntress on December 25, 2009, 11:45 am
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>
>> wrote:
>>
>>>
>>>> wrote:
>>>>
>>>>>
>>>>>> news:9b84a$4b305027$18f55223
>>>>>> $32348@allthenewsgroups.com:
>>>>>>
>>>>>>>
>>>>>>>>
>>>>>>>>
>>>>>>>> >
>>>>>>>> > It's only a "death panel" if you're denied treatment.
>>>>>>>
>>>>>>>> Like cancer patients denied treatment because of an
>>>>>>>> acne condition they had decades earlier?
>>>>>>>>
>>>>>>>> http://energycommerce.house.gov/Press_111/20090616/testimony_beaton.pdf
>>>>>>>
>>>>>>>> Like cancer patients whose treatment is just "too
>>>>>>>> expensive" for insurance companies to bother with?
>>>>>>>>
>>>>>>>> http://www.kmbc.com/health/13298245/detail.html
>>>>>>>
>>>>>>> If a private insurance company denies you treatment, you have
>>>>>>> alternatives available to you.
>>>>>>
>>>>>>
>>>>>> If your insurance company drops you after you
>>>>>> are diagnosed with cancer - as in the above cases -
>>>>>> you have the alternative of just dying, because no
>>>>>> company is going to cover you.
>>>>>
>>>>>"According to the American Medical Association's National Health
>>>>>Insurer
>>>>>Report Card for 2008, the government's health plan, Medicare, denied
>>>>>medical
>>>>>claims at nearly double the average for private insurers: Medicare
>>>>>denied
>>>>>6.85% of claims. The highest private insurance denier was Aetna @ 6.8%,
>>>>>followed by Anthem Blue Cross @ 3.44, with an average denial rate of
>>>>>medical
>>>>>claims by private insurers of 3.88%
>>>>>
>>>>>In its 2009 National Health Insurer Report Card,
>>>>
>>>>
>>>> http://www.ama-assn.org/ama1/pub/upload/mm/368/2008-nhirc-report-card.pdf
>>>>
>>>>>the AMA reports that
>>>>>Medicare denied only 4% of claims-a big improvement, but outpaced
>>>>>better
>>>>>still by the private insurers. The prior year's high private denier,
>>>>>Aetna,
>>>>>reduced denials to 1.81%-an astounding 75% improvement-with similar
>>>>>declines
>>>>>by all other private insurers, to average only 2.79%.
>>>>>
>>>>>Maybe there's something to be said for the need to keep your customers
>>>>>satisfied in order to make that profit after all."
>>>>>
>>>>>http://www.independent.org/blog/?p=4459
>>>>
>>>> IF you look at the Medicare data again you may note that it was
>>>> usually
>>>> a case of improper billing that needed to be corrected, such as
>>>> something left off the bill (like the patient's name) and just
>>>> needed to be properly rebilled.
>>>> Plus perhaps some attempted fraud, which they can
>>>> probably do better at reducing now that the dems (I assume) will
>>>> again allow them to do (the rethugs had defunded the fraud checkers
>>>> it seemed).
>>>
>>>I think the people that put this report together are well aware of how
>>>screwed up the Medicare/Medicaid systems are.
>>>>
>>>> Unlike the stuff you copied you need to check
>>>> the codes at
>>>> http://www.ama-assn.org/ama1/pub/upload/mm/368/2008-nhirc-report-card.pdf
>>>> to see what is really going on.
>>>
>>>As I said above the people that put this report together are aware of the
>>>short falls of the Medicare/Medicaid systems.
>>
>> I think you clearly failed to check the actual report & the codes
>> as well as grasp my post.
>> What you copied from somewhere was clearly intentionally misleading.
>
> I did check the report and the codes. Maybe I didn't grasp you post, but
> I wasn't trying to be misleading. What I was trying to get across was
> that Medicare is in trouble ... it rife with inefficiencies and fraud.
> Countries that have govt run universal care insure everyones healthcare
> but fall down when it comes to actual delivering health care. Annual
> Medicare fraud is estimated at $60 billion. Annual profits for the top
> ten insurance companies are $8 billion. The $60 billion could pay the
> premiums for lots of people who are uninsured. In countries like Canada
> and the UK who have universal healthcare there is rationing, shortage and
> poor service.
> "As 60 Minutes reported last week, Medicare fraud is rampant and has now
> replaced the cocaine (ahem) business as the major criminal activity in
> South Florida. Both 60 Minutes and the Washington Post report that
> Medicare fraud now costs American taxpayers roughly $60 billion a year.
> That may sound like a lot of money, but surely it pales next to the
> extraordinary profits of private insurance companies, right?
>
> Well, let's see.... Last year, the profits of the ten largest insurance
> companies in America were just over $8 billion -- combined. No single
> insurance company made even five percent of what Medicare reportedly loses
> in fraud."
>
> http://www.weeklystandard.com/weblogs/TWSFP/2009/10/post_145.asp
I think you have some misconceptions there, Joe. Rates of fraud are roughly
the same with private and public insurers. The high estimate for total
medical fraud in the US is $220 billion, probably based on the same kind of
estimate that pegs Medicare fraud at $60 billion.
In any case, if you want to see a brief, current analysis without many
numbers, and references to a variety of sources, this is a good place to
start:
http://www.gwumc.edu/sphhs/departments/healthpolicy/dhp_publications/pub_uploads/dhpPublication_EFDAD1BC-5056-9D20-3D3D36632A4F2163.pdf
Or, you could look at this, which is a one-page summary from the National
Health Care Anti-fraud Association:
http://www.nhcaa.org/eweb/DynamicPage.aspx?webcode=anti_fraud_resource_centr&wpscode=TheProblemOfHCFraud
The target of news media is government-run programs, because the idea that
our tax money is being given to fraudsters is a natural news lead,
guaranteed to get people angry. But a fair analysis shows that it's a
worldwide problem for both private and public insurers, and that the rates
of fraud don't vary much between them.
--
Ed Huntress
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